Gracitelli Mauro Emilio Conforto, Ferreira Arnaldo Amado, Benegas Eduardo, Malavolta Eduardo Angeli, Sunada Edwin Eiji, Assunção Jorge Henrique
Institute of Orthopedics and Traumatology of Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
Acta Ortop Bras. 2013 May;21(3):139-43. doi: 10.1590/S1413-78522013000300002.
To evaluate the safety of arthroscopic Latarjet procedure in cadavers.
: Twelve cadaveric shoulders underwent arthroscopic Latarjet procedure in our laboratory for arthroscopy, by four different surgeons. Following surgery, the specimens were subjected to radiographic examination and evaluated by an independent examiner. Nineteen parameters were evaluated, including the coracoid graft fixation, positioning and angulation of the screws, neurological damage and integrity of tendons.
: Four procedures were considered to be satisfactory, with no difference among the surgeons. The mean angulation of the screws was 27.2°. The subscapularis splitting was, on average, 17.8mm from the upper edge. The coracoid graft was properly positioned relative to equator of the glenoid in 11 cases. There was no injury to the axillary or musculocutaneous nerves. The main complications were: interposition of soft tissue, suprascapular nerve injury, articular deviation of the graft, diastasis and conjoined tendon injury.
: The arthroscopic Latarjet procedure is a complex technique in which each step must be precise to reduce the risk of complications. Our study showed a high risk of failure of the procedure. Level of Evidence IV, Case Series .
评估关节镜下Latarjet手术在尸体上的安全性。
在我们的实验室中,由四位不同的外科医生对12具尸体肩部进行关节镜下Latarjet手术。术后,对标本进行放射学检查,并由一名独立检查者进行评估。评估了19项参数,包括喙突移植固定、螺钉的定位和角度、神经损伤以及肌腱的完整性。
四项手术被认为是满意的,外科医生之间无差异。螺钉的平均角度为27.2°。肩胛下肌劈开平均距离上缘17.8mm。11例中喙突移植相对于肩胛盂赤道的位置正确。未发生腋神经或肌皮神经损伤。主要并发症有:软组织嵌入、肩胛上神经损伤、移植关节面偏斜、骨缝分离和联合肌腱损伤。
关节镜下Latarjet手术是一项复杂的技术,其中每个步骤都必须精确以降低并发症风险。我们的研究表明该手术失败风险较高。证据级别IV,病例系列。